Ask Dr. Amini
Q. What is periodontal disease?
A. Periodontal (gum) diseases including gingivitis
and periodontitis, are serious infections that, left
untreated, can lead to tooth loss. Periodontal disease
can affect one tooth or many teeth. The main cause of
periodontal disease is bacterial plaque, a sticky,
colorless films that constantly forms on your teeth.
However, factors like the following also affect the
health of your gums.
Q. How does one know if they have a gum disease?
A: Periodontal disease is often silent, meaning symptoms
may not appear until an advanced stage of the disease.
However, warning signs of periodontal disease include
the following:
- Red, swollen or tender gums or other pain in
your mouth
- Bleeding while brushing, flossing, or eating
hard food
- Gums that are receding or pulling away from the
teeth, causing the teeth to look longer than before
- Loose or separating teeth
- Pus between your gums and teeth
- Sores in your mouth
- Persistent bad breath
- A change in the way your teeth fit together when
you bite
- A change in fit of partial dentures
Q. How is periodontal disease treated?
A. Following are some of the procedures that
periodontists use to treat patients diagnosed with a
periodontal (gum) disease. A periodontist is a dentist
who specializes in the prevention, diagnosis and
treatment of periodontal disease. Periodontists receive
extensive training in these areas, including three
additional years of education beyond dental school.
Periodontists are familiar with the latest techniques
for diagnosing and treating periodontal disease. In
addition, they can perform cosmetic periodontal
procedures to help you achieve the smile you desire.
Non-Surgical Treatments
American Association of Periodontology treatment
guidelines stress that periodontal health should be
achieved in the least invasive and most cost-effective
manner. This is often accomplished through non-surgical
periodontal treatment, including scaling and root
planning (a careful cleaning of the root surfaces to
remove plaque and calculus [tartar] from deep
periodontal pockets and to smooth the tooth root to
remove bacterial toxins), followed by adjunctive therapy
such as local delivery antimicrobials and host
modulation, as needed on a case-by-case basis.
Q. Who gets periodontal disease?
A. Poor oral hygiene and home care—Twice a day proper
brushing and flossing your teeth and visiting your
dentist at least twice a year can help prevent gum
disease.
Puberty, Pregnancy and Menopause—A
woman’s health needs are unique. Though brushing and
flossing daily, a healthy diet, and regular exercise are
important for oral health throughout life, there are
certain times in a woman’s live when extra care is
needed—times when you mature and change such as puberty
or menopause, and times when you have special health
needs, such an menstruation or pregnancy. During these
particular times, a woman’s body experiences hormonal
changes that can affect many of the tissues in your
body, including the gums. Your gums can become
sensitive, and at times react strongly to the hormonal
fluctuations. This may make you more susceptible to gum
disease. Additionally, recent studies suggest that
pregnant women with gum disease are seven times more
likely to deliver preterm, low birth weight babies.
Medications—Some drugs,
such as oral contraceptives, anti-depressants,
anti-seizure, and certain heart medicines, can affect
your oral health. Just as you notify your pharmacist and
other health care providers of all the medicines you are
taking and any changes in your overall health, you
should also inform your dental care provider.
Smoking/Tobacco Use—As you
probably already know, tobacco use is linked with many
serious illnesses such as cancer, lung disease and heart
disease, as well as numerous other health problems. What
you may not know is that tobacco users also are at
increased risk for periodontal disease. In fact, recent
studies have shown that tobacco use may be one of the
most significant risk factors in the development and
progression of periodontal disease.
Clenching and grinding your teeth—Has
anyone ever told you that you grind your teeth at night?
Is your jaw sore from clenching your teeth when you’re
taking a test or solving a problem at work? Clenching or
grinding your teeth can put excess force on the
supporting tissues of the teeth and could speed up the
rate at which these periodontal tissues are destroyed.
Diabetes—Diabetes is a
disease that causes altered levels of sugar in the
blood. Diabetes develops from either a deficiency in
insulin production (a hormone that is the key component
in the body’s ability to use blood sugars) or the body’s
inability to use insulin correctly. According to the
American Diabetes Association, approximately 16 million
American have diabetes; however, more than half have not
been diagnosed with this disease. If you are diabetic,
you are at higher risk for developing infections,
including periodontal disease. These infections can
impair the ability to process and/or utilize insulin,
which may cause your diabetes to be more difficult to
control and your infection to be more severe than a
non-diabetic.
Most periodontists would agree that after scaling and
root planning, many patients including women who are
pregnant or nursing do not require any further active
treatment, including surgical therapy. However, the
majority of patients will require ongoing maintenance
therapy to sustain health. Non-surgical therapy does
have its limitations, however, and when it does not
achieve periodontal health, surgery may be indicated to
restore periodontal anatomy damaged by periodontal
diseases and to facilitate oral hygiene practices.
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